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Comparing Non-Medical Sex Selection and Saviour Sibling Selection in the Case of JS and LS v Patient Review Panel: Beyond the Welfare of the Child?

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Abstract

The national ethical guidelines relevant to assisted reproductive technology (ART) have recently been reviewed by the National Health and Medical Research Council (NHMRC). The review process paid particular attention to the issue of non-medical sex selection, although ultimately, the updated ethical guidelines maintain the pre-consultation position of a prohibition on non-medical sex selection. Whilst this recent review process provided a public forum for debate and discussion of this ethically contentious issue, the Victorian case of JS and LS v Patient Review Panel (Health and Privacy) [2011] VCAT 856 provides a rare instance where the prohibition on non-medical sex selection has been explored by a court or tribunal in Australia. This paper analyses the reasoning in that decision, focusing specifically on how the Victorian Civil and Administrative Tribunal applied the statutory framework relevant to ART and its comparison to other uses of embryo selection technologies. The Tribunal relied heavily upon the welfare-of-the-child principle under the Assisted Reproductive Treatment Act 2008 (Vic). The Tribunal also compared non-medical sex selection with saviour sibling selection (that is, where a child is purposely conceived as a matched tissue donor for an existing child of the family). Our analysis leads us to conclude that the Tribunal’s reasoning fails to adequately justify the denial of the applicants’ request to utilize ART services to select the sex of their prospective child.

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Notes

  1. The NHMRC ART guidelines further restrict the use of PGD to screening out genetic conditions “that would severely limit the quality of life of the person who would be born” (NHMRC 2017, ¶8.15.1, ¶8.16). The Act also imposes a presumption against treatment where a woman or her partner have been found guilty of a sexual offence, convicted of a violent offence or had a child protection order made against them (Assisted Reproductive Treatment Act 2008 (Vic), s 14(1)).

  2. It is noteworthy that section 15(1) does not specifically mention non-medical sex selection. Given this omission, the Panel is arguably not strictly required to have regard to the matters in s 15(3) in making decisions about non-medical sex selection.

  3. For example, PGD may be used to avoid the transmission of a disorder linked to an X chromosome, such as muscular dystrophy or haemophilia.

  4. Accreditation is now mandatory under Commonwealth legislation regulating embryo research and human cloning (Research Involving Human Embryos Act, ss 8 and 11).

  5. It should be noted that the Tribunal’s function in such cases is not appellate, but is instead focused on making the decision from “the shoes of the original decision maker ... on the basis of the material before it”: ABY & ABZ v Patient Review Panel (Health & Privacy) [2011] VCAT 1382, [31].

  6. Blastomere biopsy involves the removal of one or two cells from the embryo once it has reached the eight-cell stage (referred to as the “cleavage stage,” which occurs three days after fertilisation), and this has been reported as less safe than trophectoderm biopsy, which is used to remove cells at the “blastocyst stage” (five days after fertilisation) (Scott, Long, and Scott 2013).

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Correspondence to Malcolm K. Smith.

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Smith, M.K., Taylor-Sands, M. Comparing Non-Medical Sex Selection and Saviour Sibling Selection in the Case of JS and LS v Patient Review Panel: Beyond the Welfare of the Child?. Bioethical Inquiry 15, 139–153 (2018). https://doi.org/10.1007/s11673-018-9838-9

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